Update on 18F-Fluciclovine PET for Prostate Cancer Imaging

J Nucl Med. 2018 May;59(5):733-739. doi: 10.2967/jnumed.117.204032. Epub 2018 Mar 9.

Abstract

PET is a functional imaging method that can exploit various aspects of tumor biology to enable greater detection of prostate cancer than can be provided by morphologic imaging alone. Anti-1-amino-3-18F-flurocyclobutane-1-carboxylic acid (18F-fluciclovine) is a nonnaturally occurring amino acid PET radiotracer that was recently approved by the U.S. Food and Drug Administration for detection of suspected recurrent prostate cancer. The tumor-imaging features of this radiotracer mirror the upregulation of transmembrane amino acid transport that occurs in prostate cancer because of increased amino acid metabolism for energy and protein synthesis. This continuing medical education article provides an overview on 18F-fluciclovine PET diagnostic capabilities for primary and metastatic disease, including reviews of published comparisons to conventional imaging and other molecular imaging agents. Additionally, the imaging procedure and image interpretation are detailed, including physiologic and pathologic uptake patterns and pitfalls.

Keywords: 18F-fluciclovine; amino acid; prostate cancer.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Carboxylic Acids / chemistry*
  • Cyclobutanes / chemistry*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Positron-Emission Tomography*
  • Prostatic Neoplasms / diagnostic imaging*
  • Radiopharmaceuticals / chemistry
  • Radiotherapy Planning, Computer-Assisted
  • Sensitivity and Specificity
  • Up-Regulation

Substances

  • Carboxylic Acids
  • Cyclobutanes
  • Radiopharmaceuticals
  • fluciclovine F-18